City Center Residential Practice Period Application

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Page 1

SAN FRANCISCO ZEN CENTER CITY CENTER

Fall 2023 Residential Practice Period Application

October 2 - December, 9 2023

Led by Ryushin Paul Haller

Fields marked with an * asterisk are required.

NOTE: You are applying to participate as a Residential Participant (residing at 300 Page St /City Center for the duration of the Practice Period).

Personal Information

First Name

Last Name

Date of Birth

Use month/day/year with 4-digit year

Phone (Cell)

Alternate Phone

I identify my gender as (for housing purposes)

Gender Pronouns (i.e. he/him, she/her, they/their, or something else?)

Address

Mailing Street

Mailing City

Country

State

Province

Zip / Postal Code

Emergency Contact Information

Emergency Contact Name

Relationship

Address

Cell Phone

Alternate Phone

PART II: Personal Statement

What motivates you to join this practice period? For instance, what is it you are searching for, inspired by, or would like to investigate in your life?

A brief personal history, and specifically, what do you consider to be the most important manifestations of your Buddhist practice in your everyday life? What do you do and / or have done - in your work life, in family life, in the larger world, in the monastery - that you consider to be an important manifestation of your commitment to Buddhist practice?

Completed SFZC Practice Periods, intensives and sesshins and dates (if applicable)

Briefly include other formal Buddhist practice experience; include date(s), and location(s)

Have you received the Buddhist precepts?

Date Received Precepts

Received Precepts from whom?

Have you been ordained as a Buddhist priest?

Ordination Date

Ordained by whom?

Are you currently practicing with a Buddhist teacher or practice leader?

YesNo

Name of Primary Teacher/Practice Leader

Are they an SF Zen Center Teacher?

YesNo

We request a letter of recommendation from your teacher if they are not a SF Zen Center teacher. Please provide contact information so that we may reach your teacher if necessary. Please include the teacher's name, address and phone number.

Preferred Zendo Seating Type

If Other type seating describe/explain

In order to help with the assignment of housing, please indicate if you snore or use a CPAP machine.

Page 2

Medical

Any medical problems such as back or knee problems, repetitive stress (RSI), food or other serious allergies?

Do you have any significant physical, psychological, or emotional difficulties, particularly those for which you have received professional help or been hospitalized (Please list dates, if applicable)?

Do you have a history of alcohol or substance abuse (Please list any treatment programs and dates)?

Please specify any perscription medications, and briefly describe the conditions being treated.

Any limitations that would prevent you from completely following the practice period schedule?

Vaccinations

At this time, City Center is only able to invite people to be residents who are fully vaccinated and have received a booster shot when eligible.

Do you have a current flu shot?

Are you able to get a flu shot before the start of the practice period?

Have you been vaccinated against Covid-19?

Will you be fully vaccinated by the start of the practice period?

Are you able to completely follow the Covid-19 protocols while at City Center?

What vaccine did you receive? How many doses have you received and what was the date of your last dose?

Travel/Stay (residential applicants)

Will you be catching a flight or traveling via public transport within 14 days of your arrival?

How will you support yourself during your stay at City Center? What are your plans following the practice period?

Are you interested in continuing in residential practice at City Center after this practice period?

How long to you intend to stay in residence at City Center?

Describe your interests and/or intentions if continuing residential practice at City Center

Page 3: Participation in the Practice Period

Full participation in a City Center practice period requires:

Monday through Saturday attendance at morning and evening meditation, service, and temple cleaning
Attendance at twice-weekly dharma talks, a weekly class, formal oryoki meals and ceremonies
Weekly meal preparation and dishwashing shifts and temple jobs
Following the City Center Practice Guidelines
Refraining from recreational drug and alcohol use
Refraining from beginning any new sexual relationship

Note: the times and offerings here may vary from the final schedule but give you a good idea of what our time together will look like. Final details of the schedule will be provided with confirmation materials.

Please designate your level of involvement in the Practice Period

Residential applicants apply to take part in either a "full" schedule or a "limited" schedule. The "full" schedule involves working in the temple full-time (Monday through Friday for a full work day). The "limited" option allows participants to live in the temple, but without taking up full-time temple work, such that the participant can continue engaging in their normal livelihood. Please indicate your preference by marking the appropriate option.

Full ScheduleLimited Schedule

Full Schedule (WPA)

Shared RoomPrivate Room (availability is limited and reserved first for those with special needs)

Limited Schedule

Shared RoomPrivate Room (availability is limited and reserved first for those with special needs)

I have read, understood, and kept a copy of the Pure Standards for Residential Zen Training, and reviewed the practice period schedule . If accepted, I agree to observe the guidelines and participate fully in the practice period.

Agreed

Page 4

Payment

Payment is full is required before arrival at City Center unless another arrangement is made in advance. See the Intensive webpage for fees.

Application Fee

Are you currently an SFZC Resident (at Green Gulch, City Center or Tassajara)?

YesNo

Payment of $30 may be paid here. Visa/MC only.

Name on Card

Card Number

Code

Billing Email

Please upload a recent, cropped headshot. There is a free online cropping tool at cropp.me.

Upload a photo from your device

All first-time residential applicants are required to meet with the City Center Director prior to the application due date. If a physical meeting is not practical, a Zoom or telephone appointment can be made. You will be contacted to find a mutually convenient time for this meeting. If you have any questions about financial assistance, work exchange, or any other matters related to the application process, please contact the temple coordinator at ellen.simpson@sfzc.org

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